Probiotic may be used as an effective treatment to avoid antibiotic-induced diarrhea or viral or bacterial gastrointestinal infections; so say researchers at Albert Einstein College of Medicine of Yeshiva University.

At least one in five people on antibiotics stop taking their full course of antibiotic therapy due to diarrhea, and according to the study, Physicians could help patients avoid this problem by prescribing probiotics.

Antibiotics target "bad" bacteria but may also kill the "good" bacteria in the large intestine, leading to diarrhea. Diarrhea can also result from bacterial and viral infections.

Probiotics-cultures of "good" microorganisms similar to those normally found in the gut - have been promoted as restoring the microbial balance disrupted by antibiotics and infections. Probiotic bacterial strains are added to certain yogurts and brands of miso and other fermented foods, and are also available as powders and pills sold in health food stores.

In the study, the researchers reviewed the medical literature and found seven, high-quality studies in which probiotics were administered to people.

And they concluded that the studies support the use of probiotics for avoiding diarrhea resulting from antibiotic use or from gastrointestinal viral or bacterial infections. Also, the probiotics used in these studies were found to rarely cause adverse effects, even in children.

"With the level of evidence that probiotics work and the large safety margins for them, we see no good reason not to prescribe probiotics when prescribing antibiotics. The only drawback is that probiotics are not covered by health insurance," said Dr. Benjamin Kligler, a co-author of the study and associate professor of clinical family and social medicine at Einstein.

Kligler indicated that the effects of probiotics doses are short-lived, so they should be taken throughout a course of antibiotic therapy. Also, he added that probiotics would not diminish the effectiveness of antibiotics.

The Einstein paper specifies several commercial probiotic preparations of sufficient strength to offer health benefits. Generally, probiotic doses of more than 5 billion colony-forming units per day for children and more than 10 billion colony-forming units per day for adults were associated with the best outcomes.

According to Kligler, physicians should be aware of specific brands so they can recommend only those known to be of quality.

"In our residency program, we've worked hard to train our physicians to consider probiotics as an option. Now they are pretty good at regularly prescribing probiotics when they put a patient on antibiotics. But the average doctor is not doing this, and patients often know more about probiotics than their physicians do," said Kligler.

The paper, "Probiotics," was published in the latest issue of American Family Physician.

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